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手术治疗前探索子宫内膜异位症:剖析疼痛、性功能及生活质量模式。

Exploring endometriosis before surgical treatment: unraveling pain, sexual function and quality of life patterns.

作者信息

Pereira Juliana Olavo, Kulak Jaime

机构信息

Universidade Federal do Paraná CuritibaPR Brazil Universidade Federal do Paraná, Curitiba, PR, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2025 Jul 15;47. doi: 10.61622/rbgo/2025rbgo47. eCollection 2025.

DOI:10.61622/rbgo/2025rbgo47
PMID:40673032
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12266876/
Abstract

OBJECTIVE

To identify pain, sexual function, and quality of life patterns in women with endometriosis, taking into consideration the American Society for Reproductive Medicine (ASRM) classification for endometriosis.

METHODS

A cross-sectional study of quantitative descriptive nature was conducted, including women with surgical recommendation due to endometriosis. The Numeric Pain Rating Scale, Endometriosis Health Profile, and Female Sexual Function Index tools were used for data collection. Descriptive and frequency analysis were employed. Using the K-means algorithm, cluster analysis was performed to group participants based on response similarities.

RESULTS

104 women with endometriosis were included with a median age of 35 years. The majority were classified as grade III (57.69%) and IV (25.96%) for endometriosis. There was a significant difference in the division of two clusters concerning ASRM, with ASRM IV women more frequently associated with Cluster B, while Cluster A being predominantly formed by ASRM III women. Cluster B showed significantly worse data for dyspareunia and dysuria pain levels and for all variables in the FSFI and EHP-30 instruments, except for infertility, which did not differ between the groups.

CONCLUSION

ASRM classification is not directly related to clustering. Women diagnosed with endometriosis, mostly ASRM III and IV, exhibit two distinct patterns, with one group having worse pain, sexual function and quality of life scores compared to the other group. Infertility is a crucial aspect to study concerning the quality of life of women living with the disease and aspiring for motherhood irregardless of the clustering.

摘要

目的

考虑美国生殖医学学会(ASRM)的子宫内膜异位症分类,确定子宫内膜异位症女性的疼痛、性功能和生活质量模式。

方法

进行了一项定量描述性横断面研究,纳入因子宫内膜异位症而有手术指征的女性。使用数字疼痛评分量表、子宫内膜异位症健康概况量表和女性性功能指数工具收集数据。采用描述性和频率分析。使用K均值算法进行聚类分析,根据反应相似性对参与者进行分组。

结果

纳入104例子宫内膜异位症女性,中位年龄35岁。大多数患者子宫内膜异位症被分类为III级(57.69%)和IV级(25.96%)。在ASRM方面,两个聚类的划分存在显著差异,ASRM IV级女性更常与B聚类相关,而A聚类主要由ASRM III级女性组成。B聚类在性交困难和排尿困难疼痛水平以及FSFI和EHP - 30工具中的所有变量方面的数据明显更差,但不孕在两组之间没有差异。

结论

ASRM分类与聚类没有直接关系。被诊断为子宫内膜异位症的女性,大多为ASRM III级和IV级,表现出两种不同的模式,其中一组在疼痛、性功能和生活质量评分方面比另一组更差。无论聚类情况如何,不孕都是研究患有该疾病并渴望成为母亲的女性生活质量的一个关键方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a72/12266876/9a4cf1935a88/1806-9339-rbgo-47-e-rbgo47-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a72/12266876/b7dbe05bad67/1806-9339-rbgo-47-e-rbgo47-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a72/12266876/9a4cf1935a88/1806-9339-rbgo-47-e-rbgo47-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a72/12266876/b7dbe05bad67/1806-9339-rbgo-47-e-rbgo47-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a72/12266876/9a4cf1935a88/1806-9339-rbgo-47-e-rbgo47-gf02.jpg

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本文引用的文献

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Epidemiology of infertility in women with endometriosis.子宫内膜异位症女性不孕的流行病学。
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"Free butterflies will come out of these deep wounds": A grounded theory of how endometriosis affects women's psychological health.“这些深深的伤口会释放出自由的蝴蝶”:子宫内膜异位症如何影响女性心理健康的扎根理论。
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A qualitative study of the impact of endometriosis on male partners.子宫内膜异位症对男性伴侣影响的定性研究。
Hum Reprod. 2017 Aug 1;32(8):1667-1673. doi: 10.1093/humrep/dex221.
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What Is Known and Unknown About the Association Between Endometriosis and Sexual Functioning: A Systematic Review of the Literature.关于子宫内膜异位症与性功能之间关联的已知与未知:文献系统综述
Reprod Sci. 2017 Dec;24(12):1566-1576. doi: 10.1177/1933719117707054. Epub 2017 May 31.
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Prevalence and Symptomatic Burden of Diagnosed Endometriosis in the United States: National Estimates from a Cross-Sectional Survey of 59,411 Women.美国确诊子宫内膜异位症的患病率及症状负担:基于对59411名女性的横断面调查的全国估计数
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